Clinical Types of Apraxia

 

Types of apraxia:

(1) ideomotor

(2) conduction

(3) dissociation

(4) ideational

(5) conceptual

(6) limb-kinetic

 

Ideomotor apraxia:

(1) Unable: To perform learned skilled movements. The person makes spatial and temporal errors when trying to pantomime, imitate or use an actual object. The person tends to improve with imitation.

(2) Tested By: Asking the person to pretend cutting bread with a knife.

(3) Location of Injury: In contralateral hemisphere (left lobe if right handed; right lobe is left handed) - inferior parietal lobe, premotor cortex, corpus callosum

 

Conduction apraxia:

(1) Unable: To imitate in response to a command. The person will be more impaired when imitating than when pantomiming. The failure to improve with imitation helps to distinguish this form from ideomotor apraxia.

(2) Tested By:

(3) Location of Injury: uncertain

 

Dissociation apraxia:

(1) Unable: To perform skilled movements in response to a stimulus in one modality but can perform movements correctly in a different modality. The patient may be unable to pantomime with the hands but have no problem with imitation or use of objects.

(2) Tested By: Ask to pantomime to command.

(3) Location of Injury: Corpus callosum

 

Ideational apraxia:

(1) Unable: To correctly carry out a series of actions. The patient will have difficulty sequencing actions in the required order.

(2) Tested By: Asking the patient to perform a task that requires a series of actions, such as prepare and pack a sandwich.

(3) Location of Injury: Diffuse brain damage, left parietal lobe, frontal lobe

 

Conceptual apraxia:

(1) Unable: To solve a mechanical problem because of content or tool selection errors. When shown a tool the person may use it inappropriately. When shown the target for a tool the person may select the wrong tool. The person may be unable to describe the function of a tool.

(2) Tested By: Ask the person to pantomime how to use a screwdriver. Ask the person how to drive in a nail.

(3) Location of Injury: In hemisphere contralateral to preferred hand, with degenerative dementias.

 

Limb-kinetic apraxia:

(1) Unable: To make finely graded and independent finger movements (loss of deftness)

(2) Tested By: Unable to pick up a dime off the table or to use a pegboard.

(3) Location of Injury: In contralateral hemisphere (corticospinal tracts)